Intra-catheter endoscopy for various shunting procedures—a retrospective analysis on surgical practicability, catheter placement, and failure rates
Antes S, Linsler S, Salah M, Senger S, Oertel J (2017)
Publication Type: Journal article
Publication year: 2017
Journal
Book Volume: 159
Pages Range: 1991-1998
Journal Issue: 10
DOI: 10.1007/s00701-017-3264-3
Abstract
Background: The long-term function of a cerebral shunt is directly influenced by the placement of the ventricle catheter. In this work, an intra-luminal endoscope for best possible catheter positioning was used. Practicability, postoperative imaging, and shunt failure rates were retrospectively evaluated. Methods: Between January 2012 and June 2016, an intra-catheter endoscope was applied in 71 procedures. Endoscopic technique was used for catheter placement in first-time shunting or cerebrospinal fluid reservoir insertion (n = 38), revision surgery in proximal shunt failure (n = 13), and various intraventricular stenting procedures (n = 20). Catheter positioning was graded on postoperative imaging using a four-point scale. All patients were regularly followed up (mean, 31.6 months) to recognize shunt failures. Results: Endoscopic application could be completed as intended in 68 of 71 procedures. Postoperative imaging could exclude complete misplacement of all catheters, but optimal positioning was only achieved in 64.7% (44/68 cases). Four catheters had to be revised due to malfunction (failure rate, 5.8%). Another five catheters had to be removed due to infectious complications or wound-healing disorders. Direct correlations between catheter complications and suboptimal catheter positioning were not seen. Slit or distorted ventricles also did not prove to be a risk factor for the observed complications. Conclusions: Versatile application possibilities of the intra-catheter endoscope reflect the advantages of the technique. Independent of the performed procedure, unintended positionings or even complete catheter misplacements could be avoided. However, in more than one-third of all cases, suboptimal catheter placements became obvious. Interestingly, negative influences on later shunt failures were not seen.
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Germany (DE)How to cite
APA:
Antes, S., Linsler, S., Salah, M., Senger, S., & Oertel, J. (2017). Intra-catheter endoscopy for various shunting procedures—a retrospective analysis on surgical practicability, catheter placement, and failure rates. Acta Neurochirurgica, 159(10), 1991-1998. https://doi.org/10.1007/s00701-017-3264-3
MLA:
Antes, Sebastian, et al. "Intra-catheter endoscopy for various shunting procedures—a retrospective analysis on surgical practicability, catheter placement, and failure rates." Acta Neurochirurgica 159.10 (2017): 1991-1998.
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